Are we ready yet?: New graduate nurses' experience of workplace violence and agression and their sense of readiness

Abstract

Aim: The aim of this study was explore new graduate nurses’ experience of WPVA and their sense of readiness for responding to such events. Background: Considerable evidence exists indicating that workplace violence and aggression (WPVA) is a concern for nurses working in all sectors of health. The impact of exposure can be far reaching for nurses themselves, those they care for and for organisations that employ them. There is a need to prepare nurses adequately to enable them to respond safely and competently to WPVA. Method: This study used a qualitative descriptive approach to explore the experience of seven new graduate nurses who were employed in a range of sectors, including Mental Health and General Medical units. Data was collected using semi structured interviews which were recorded and transcribed by the researcher. Thematic analysis was used to analyse the data which generated three themes and associated subthemes. Findings: The themes identified were labelled ‘Part of the Journey’, ‘Towards Self Efficacy’ and ‘Maintaining Integrity’. The themes reflect the diversity of experiences and challenges these nurses faced when exposed to WPVA. ‘Part of the Journey’ captured the nature of the experience including physical and verbal assaults, and exposure to horizontal violence. Factors that influenced this experience and how participants made sense of them were identified. ‘Towards Self-Efficacy’ captured the effects of exposure which were mostly negative and psychological. These included lowered self esteem and confidence, fear and reduced engagement with clients. Only minor physical injuries were sustained. However, positive effects that contributed to the nurse’s self-efficacy, such as increased risk awareness, and improved understanding of client centered care and duty of care were also identified. ‘Maintaining Integrity’ captured the vulnerability participants felt with several aspects of WPVA. Vulnerability was associated with trying to ‘fit in’ with colleagues by not complaining and attempting to deal with WPVA as competently as more experienced staff. However, the new graduates also identified coping strategies used to maintain integrity and counteract the vulnerability they experienced. They described entering into processes of reconciliation with clients or staff involved, reflective practices and supervision and seeking the support of others. Conclusion: While a large body of literature on WPVA in the health sector exists, less of it focuses specifically on new graduate nurses’ experience and their readiness for responding to it. This study provides insight from nurses who are at the most vulnerable stage of their career and includes suggestions on how they could be better prepared. In addition it contributes to the understanding of WPVA by providing a contemporary, New Zealand perspective.